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American Journal of Clinical Dermatology
Published in: American Journal of Clinical Dermatology 4/2015

01-08-2015 | Review Article

Hand Dermatitis: A Review of Clinical Features, Prevention and Treatment

Authors: Dimitar Antonov, Sibylle Schliemann, Peter Elsner

Published in: American Journal of Clinical Dermatology | Issue 4/2015

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Abstract

Hand dermatitis is a socially significant health problem. This review provides a discussion on the clinical features and patterns as well as the differential diagnosis of hand dermatitis, because these are essential for proper diagnosis in clinical practice. The morphology, however, is poorly related to the etiology in chronic cases. In all cases of chronic hand dermatitis, a full diagnostic examination should be undertaken and the etiology should be clarified and addressed in the treatment concept, instead of just moving directly from a morphological diagnosis to therapy. Preventive measures should be included in the treatment concept according to etiology. A stepwise approach for escalating therapy is advised, including basic topical therapy, topical corticosteroids, calcineurin inhibitors, as well as phototherapy and systemic therapy with corticosteroids, alitretinoin, cyclosporine, methotrexate, azathioprine, and others.
Literature
1.
2.
Diepgen T, Elsner P, Schliemann S, Fartasch M, Köllner A, Skudlik C, et al. Management von Handekzemen Leitlinie ICD-10-Ziffer: L20. L23. L24. L25. L30. J Dtsch Dermatol Ges. 2009;7(s3):s1–16.PubMed
3.
4.
Diepgen TL, Andersen KE, Chosidow O, Coenraads PJ, Elsner P, English J, et al. Guidelines for diagnosis, prevention and treatment of hand eczema. J Dtsch Dermatol Ges. 2015;13(1):e1–22.PubMedCrossRef
5.
6.
7.
Elsner P, Schliemann S. Pitfalls and errors in patch testing: suggestions for quality assurance. In: Lachapelle JM, editor. Patch testing tips. Berlin: Springer; 2014. p. 27–35.CrossRef
8.
Scalone L, Cortesi PA, Mantovani LG, Belisari A, Ayala F, Fortina AB, et al. Clinical epidemiology of hand eczema in patients accessing dermatological reference centres: results from Italy. Br J Dermatol. 2015;172(1):187–95. doi:10.​1111/​bjd.​13220.PubMedCrossRef
9.
10.
Freeman S, Maibach H. Study of irritant contact dermatitis produced by repeat patch test with sodium lauryl sulfate and assessed by visual methods, transepidermal water loss, and laser Doppler velocimetry. J Am Acad Dermatol. 1988;19(3):496–502.PubMedCrossRef
11.
Ruppert L, Apfelbacher C, Molin S, Bauer A, Mahler V, Schmitt J, et al. Itching in patients with chronic hand eczema: data from the CARPE registry. Dermatology. 2014;229(2):146–53. doi:10.​1159/​000362901.PubMedCrossRef
12.
13.
14.
15.
Kutzner H, Wurzel RM, Wolff HH. Are acrosyringia involved in the pathogenesis of “dyshidrosis”? Am J Dermatopathol. 1986;8(2):109–16.PubMedCrossRef
16.
17.
Resnik KS, Kantor GR, Lessin SR, Kadin ME, Chooback L, Cooper HS, et al. Mycosis fungoides palmaris et plantaris. Arch Dermatol. 1995;131(9):1052–6.PubMedCrossRef
18.
19.
20.
Held E, Mygind K, Wolff C, Gyntelberg F, Agner T. Prevention of work related skin problems: an intervention study in wet work employees. Occup Environ Med. 2002;59(8):556–61.PubMedCentralPubMedCrossRef
21.
Jungbauer FH, van der Harst JJ, Groothoff JW, Coenraads PJ. Skin protection in nursing work: promoting the use of gloves and hand alcohol. Contact Dermatitis. 2004;51(3):135–40.PubMedCrossRef
22.
23.
Weisshaar E, Radulescu M, Bock M, Albrecht U, Diepgen TL. Educational and dermatological aspects of secondary individual prevention in healthcare workers. Contact Dermatitis. 2006;54(5):254–60.PubMedCrossRef
24.
Seyfarth F, Schliemann S, Antonov D, Elsner P. Teaching interventions in contact dermatitis. Dermatitis. 2011;22(1):8–15.PubMed
25.
26.
Kappes UP, Goritz N, Wigger-Alberti W, Heinemann C, Elsner P. Tandem application of sodium lauryl sulfate and n-propanol does not lead to enhancement of cumulative skin irritation. Acta Derm Venereol. 2001;81(6):403–5.PubMedCrossRef
27.
28.
29.
Kutting B, Baumeister T, Weistenhofer W, Pfahlberg A, Uter W, Drexler H. Effectiveness of skin protection measures in prevention of occupational hand eczema: results of a prospective randomized controlled trial over a follow-up period of 1 year. Br J Dermatol. 2009. doi:10.​1111/​j.​1365-2133.​2009.​09485.​x.
30.
31.
32.
De Paepe K, Hachem JP, Vanpee E, Goossens A, Germaux MA, Lachapelle JM, et al. Beneficial effects of a skin tolerance-tested moisturizing cream on the barrier function in experimentally-elicited irritant and allergic contact dermatitis. Contact Dermatitis. 2001;44(6):337–43 (cod440604 [pii]).PubMedCrossRef
33.
Ramsing DW, Agner T. Preventive and therapeutic effects of a moisturizer. An experimental study of human skin. Acta Derm Venereol. 1997;77(5):335–7.PubMed
34.
35.
36.
Nilsson E, Henning C, Hjorleifsson ML. Density of the microflora in hand eczema before and after topical treatment with a potent corticosteroid. J Am Acad Dermatol. 1986;15(2 Pt 1):192–7.PubMedCrossRef
37.
Frosch PJ, Schulze-Dirks A. Contact allergy caused by polidocanol (thesit). Hautarzt. 1989;40(3):146–9.PubMed
38.
Uter W, Geier J, Fuchs T. Contact allergy to polidocanol, 1992 to 1999. J Allergy Clin Immunol. 2000;106(6):1203–4 (S0091674900870852 [pii]).PubMedCrossRef
39.
Veenhuis RT, van Horssen J, Bos RP, Anzion RB, Van Der Valk PG. Highly increased urinary 1-hydroxypyrene excretion rate in patients with atopic dermatitis treated with topical coal tar. Arch Dermatol Res. 2002;294(4):168–71. doi:10.​1007/​s00403-002-0311-5.PubMedCrossRef
40.
Luger T, Loske KD, Elsner P, Kapp A, Kerscher M, Korting HC, et al. Topical skin therapy with glucocorticoids–therapeutic index. J Dtsch Dermatol Ges. 2004;2(7):629–34.PubMedCrossRef
41.
42.
Veien NK, Olholm Larsen P, Thestrup-Pedersen K, Schou G. Long-term, intermittent treatment of chronic hand eczema with mometasone furoate. Br J Dermatol. 1999;140(5):882–6 (bjd2819 [pii]).PubMedCrossRef
43.
Hachem JP, De Paepe K, Vanpee E, Kaufman L, Rogiers V, Roseeuw D. Combination therapy improves the recovery of the skin barrier function: an experimental model using a contact allergy patch test combined with TEWL measurements. Dermatology. 2001;202(4):314–9 (drm02314 [pii]).PubMedCrossRef
44.
45.
Isaksson M, Bruze M. Repetitive usage testing with budesonide in experimental nickel–allergic contact dermatitis in individuals hypersensitive to budesonide. Br J Dermatol. 2001;145(1):38–44 (bjd4279 [pii]).PubMedCrossRef
46.
Uter W, de Padua CM, Pfahlberg A, Nink K, Schnuch A, Lessmann H. Contact allergy to topical corticosteroids–results from the IVDK and epidemiological risk assessment. J Dtsch Dermatol Ges. 2009;7(1):34–41, 34–42. doi:10.​1111/​j.​1610-0387.​2008.​06844.​x.
47.
48.
49.
Queille-Roussel C, Graeber M, Thurston M, Lachapelle JM, Decroix J, de Cuyper C, et al. SDZ ASM 981 is the first non-steroid that suppresses established nickel contact dermatitis elicited by allergen challenge. Contact Dermatitis. 2000;42(6):349–50.PubMedCrossRef
50.
Thelmo MC, Lang W, Brooke E, Osborne BE, McCarty MA, Jorizzo JL, et al. An open-label pilot study to evaluate the safety and efficacy of topically applied tacrolimus ointment for the treatment of hand and/or foot eczema. J Dermatol Treat. 2003;14(3):136–40 (ECGNGAJB45URRKDW [pii]).CrossRef
51.
Ring J, Barker J, Behrendt H, Braathen L, Darsow U, Dubertret L, et al. Review of the potential photo-cocarcinogenicity of topical calcineurin inhibitors: position statement of the European Dermatology Forum. J Eur Acad Dermatol Venereol. 2005;19(6):663–71. doi:10.​1111/​j.​1468-3083.​2005.​01315.​x.PubMedCrossRef
52.
Belsito DV, Fowler JF Jr, Marks JG Jr, Pariser DM, Hanifin J, Duarte IA, et al. Pimecrolimus cream 1 %: a potential new treatment for chronic hand dermatitis. Cutis. 2004;73(1):31–8.PubMed
53.
54.
55.
56.
57.
58.
59.
Schempp CM, Muller H, Czech W, Schopf E, Simon JC. Treatment of chronic palmoplantar eczema with local bath-PUVA therapy. J Am Acad Dermatol. 1997;36(5 Pt 1):733–7 (S0190-9622(97)80326-X [pii]).PubMedCrossRef
60.
Behrens S, von Kobyletzki G, Gruss C, Reuther T, Altmeyer P, Kerscher M. PUVA-bath photochemotherapy (PUVA-soak therapy) of recalcitrant dermatoses of the palms and soles. Photodermatol Photoimmunol Photomed. 1999;15(2):47–51.PubMedCrossRef
61.
Stege H, Berneburg M, Ruzicka T, Krutmann J. Cream PUVA photochemotherapy. Hautarzt. 1997;48(2):89–93.PubMedCrossRef
62.
Polderman MC, Govaert JC, le Cessie S, Pavel S. A double-blind placebo-controlled trial of UVA-1 in the treatment of dyshidrotic eczema. Clin Exp Dermatol. 2003;28(6):584–7 (1378 [pii]).PubMedCrossRef
63.
Petering H, Breuer C, Herbst R, Kapp A, Werfel T. Comparison of localized high-dose UVA1 irradiation versus topical cream psoralen-UVA for treatment of chronic vesicular dyshidrotic eczema. J Am Acad Dermatol. 2004;50(1):68–72. doi:10.​1016/​S0190.PubMedCrossRef
64.
Schmidt T, Abeck D, Boeck K, Mempel M, Ring J. UVA1 irradiation is effective in treatment of chronic vesicular dyshidrotic hand eczema. Acta Derm Venereol. 1998;78(4):318–9.PubMedCrossRef
65.
66.
van Coevorden AM, Kamphof WG, van Sonderen E, Bruynzeel DP, Coenraads PJ. Comparison of oral psoralen-UV-A with a portable tanning unit at home vs hospital-administered bath psoralen-UV-A in patients with chronic hand eczema: an open-label randomized controlled trial of efficacy. Arch Dermatol. 2004;140(12):1463–6. doi:10.​1001/​archderm.​140.​12.​1463.PubMed
67.
Bayerl C, Gabea A, Peiler D, Rzany B, Allgäuer T, Kleesz P, et al. Pilotstudie zur Therapie des beruflich bedingten Handekzems mit einer neuen tragbaren UVB-Bestralungseinheit. Aktuelle Derm. 1999;25:302–5.
68.
Fairris GM, Jones DH, Mack DP, Rowell NR. Superficial X-ray therapy in the treatment of constitutional eczema of the feet. Br J Dermatol. 1984;111(4):500–2.PubMedCrossRef
69.
Lofgren SM, Warshaw EM. Dyshidrosis: epidemiology, clinical characteristics, and therapy. Dermatitis. 2006;17(4):165–81.PubMedCrossRef
70.
71.
Warner JA, Cruz PD Jr. Grenz ray therapy in the new millennium: still a valid treatment option? Dermatitis. 2008;19(2):73–80.PubMed
72.
Fairris GM, Jones DH, Mack DP, Rowell NR. Conventional superficial X-ray versus Grenz ray therapy in the treatment of constitutional eczema of the hands. Br J Dermatol. 1985;112(3):339–41.PubMedCrossRef
73.
Bollag W, Ott F. Successful treatment of chronic hand eczema with oral 9-cis-retinoic acid. Dermatology. 1999;199(4):308–12 (drm99308 [pii]).PubMedCrossRef
74.
75.
Ruzicka T, Lynde CW, Jemec GB, Diepgen T, Berth-Jones J, Coenraads PJ, et al. Efficacy and safety of oral alitretinoin (9-cis retinoic acid) in patients with severe chronic hand eczema refractory to topical corticosteroids: results of a randomized, double-blind, placebo-controlled, multicentre trial. Br J Dermatol. 2008;158(4):808–17. doi:10.​1111/​j.​1365-2133.​2008.​08487.​x.PubMedCrossRef
76.
Reymann F. Two years’ experience with Tigason treatment of pustulosis palmo-plantaris and eczema keratoticum manuum. Dermatologica. 1982;164(3):209–16.PubMedCrossRef
77.
78.
Thestrup-Pedersen K, Andersen KE, Menne T, Veien NK. Treatment of hyperkeratotic dermatitis of the palms (eczema keratoticum) with oral acitretin. A single-blind placebo-controlled study. Acta Derm Venereol. 2001;81(5):353–5.PubMedCrossRef
79.
Reitamo S, Granlund H. Cyclosporin A in the treatment of chronic dermatitis of the hands. Br J Dermatol. 1994;130(1):75–8.PubMedCrossRef
80.
Granlund H, Erkko P, Eriksson E, Reitamo S. Comparison of cyclosporine and topical betamethasone-17,21-dipropionate in the treatment of severe chronic hand eczema. Acta Derm Venereol. 1996;76(5):371–6.PubMed
81.
82.
83.
84.
85.
Verma KK, Mahesh R, Srivastava P, Ramam M, Mukhopadhyaya AK. Azathioprine versus betamethasone for the treatment of parthenium dermatitis: a randomized controlled study. Indian J Dermatol Venereol Leprol. 2008;74(5):453–7.PubMedCrossRef
86.
Verma KK, Bansal A, Sethuraman G. Parthenium dermatitis treated with azathioprine weekly pulse doses. Indian J Dermatol Venereol Leprol. 2006;72(1):24–7.PubMedCrossRef
87.
88.
89.
Egan CA, Rallis TM, Meadows KP, Krueger GG. Low-dose oral methotrexate treatment for recalcitrant palmoplantar pompholyx. J Am Acad Dermatol. 1999;40(4):612–4 (S0190-9622(99)70446-9 [pii]).PubMedCrossRef
90.
91.
Pickenacker A, Luger TA, Schwarz T. Dyshidrotic eczema treated with mycophenolate mofetil. Arch Dermatol. 1998;134(3):378–9.PubMedCrossRef
92.
Bagot M, Terki N, Bacha S, Moyse D, Suck C, Revuz J. Per os desensitization in nickel contact eczema: a double-blind placebo-controlled clinico-biological study. Ann Dermatol Venereol. 1999;126(6–7):502–4 (MDOI-AD-06-1999-126-6-7-0151-9638-101019-ART4 [pii]).PubMed
93.
Handa S, Sahoo B, Sharma VK. Oral hyposensitization in patients with contact dermatitis from Parthenium hysterophorus. Contact Dermatitis. 2001;44(5):279–82 (cod440505 [pii]).PubMedCrossRef
94.
Sharma AD. Relationship between nickel allergy and diet. Indian J Dermatol Venereol Leprol. 2007;73(5):307–12.PubMedCrossRef
95.
Proksch E, Brandner JM, Jensen JM. The skin: an indispensable barrier. Exp Dermatol. 2008;17(12):1063–72.PubMedCrossRef
96.
Metadata
Title
Hand Dermatitis: A Review of Clinical Features, Prevention and Treatment
Authors
Dimitar Antonov
Sibylle Schliemann
Peter Elsner
Publication date
01-08-2015
Publisher
Springer International Publishing
Published in
American Journal of Clinical Dermatology / Issue 4/2015
Print ISSN: 1175-0561
Electronic ISSN: 1179-1888
DOI
https://doi.org/10.1007/s40257-015-0130-z

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